Abstract
BACKGROUND: Invasive mold infections (IMI) are leading infectious causes of mortality among patients with hematological malignancies. OBJECTIVES: To determine the relative contribution of host, disease, and treatment-related factors to patient survival. METHODS: An observational, retrospective cohort study reviewing the medical records of patients with hematological malignancy and IMI (2006-2016). Causes of death were classified up to 90 days after diagnosis. Kaplan-Meier and Cox regression analyses were used to determine risk factors for early, late, and overall mortality. RESULTS: Eighty-six patients with IMI were included; 29 (34%) and 41 (47%) died within 6 and 12 weeks of diagnosis, respectively. Death was attributed to IMI in 22 (53.6%) patients, all of whom died within 45 days of diagnosis. Risk factors for early mortality were elevated serum galactomannan, treatment with amphotericin B, IMI progression 3 weeks after diagnosis, and lymphoma undergoing HCT. Late mortality was associated with relapsed/refractory malignancy and elevated serum galactomannan. CONCLUSIONS: In this single-center study of patients with IMI, infections were the most frequent causes of death, and time-dependent risk factors for death were identified. These results may help direct risk-assessment and monitoring of patients undergoing treatment of IMI.